Seven in ten stillbirths in Kisumu County caused by preventable complications
Expectant mothers in Kisumu are facing a 29 per cent stillbirth rate crisis. Study reveals maternal hypertension, anaemia and infections drive preventable deaths as quality of clinical care fails mothers.
What you need to know:
- A study of 1,577 deceased babies revealing that 92 per cent of stillbirths and 93 per cent of neonatal deaths are preventable.
- Kemri found that maternal hypertension, anaemia, and infections including HIV, malaria, and chorioamnionitis are the primary killers
Imagine a mother in labour at a Kisumu hospital, her contractions growing stronger, only to be told hours later that her baby will never take a first breath. This imaginary scenario plays out 83 times daily across Kenya.
In Kisumu County, seven out of every ten stillbirths are caused by untreated pregnancy or delivery complications that could be prevented with proper medical care, a ground-breaking study has revealed.
The findings, from a comprehensive analysis of 1,577 deceased babies, expose a devastating pattern of preventable deaths that claims approximately 83 lives daily across Kenya—translating to 30,400 stillbirths annually nationwide.
According to the latest data from the Child Health and Mortality Prevention Surveillance (CHAMPS) and Pregnancy Risk Surveillance Innovation and Measurement Alliance (PRiSMA)—Gates Foundation-funded global health surveillance programmes run by Emory University in partnership with the Kenya Medical Research Institute (KemriI)—maternal hypertension, anaemia, and infections including HIV, malaria, and chorioamnionitis are the primary killers.
Dr Victor Akelo, the lead researcher, said the study found that 92 per cent of stillbirths and 93 per cent of neonatal deaths examined were preventable.
"CHAMPS engages communities, identifies and examines deaths, then feeds back results to families and communities," he explained, noting that data and specimen collection utilised minimally invasive tissue sampling (MITS).
Alarming statistics
The research, conducted on 1,355 deceased babies using MITS, found a stillbirth rate of 29 per cent—significantly higher than Kenya's national average of 19 per 1,000 total births reported by the Ministry of Health.
The World Health Organisation defines a stillbirth as a baby who dies after 28 weeks of pregnancy but before or during birth.
Half of the deceased babies sampled died during labour, while all suffered from neonatal sepsis—a bacterial infection that proved fatal. Shockingly, over 50 per cent of the dead infants were of low birth weight, with more than half being preterm deliveries.
The study revealed that 18 per cent of stillbirth deliveries were from teenage pregnancies, whilst 12 per cent came from women of advanced maternal age.
In one particularly striking case reviewed by scientists, a 20-year-old HIV-positive expectant mother who had contracted syphilis and was on antiretroviral therapy, gave birth to twins. One baby was stillborn due to obstructed labour—a condition where the baby cannot descend through the birth canal despite strong uterine contractions.
Obstructed labour, also known as labour dystocia, can result from a mismatch between the baby's size and the mother's pelvis, or factors such as malposition or malpresentation of the foetus. It can lead to serious complications including foetal distress, uterine rupture, and death.
Also read: When a baby dies before first breath
Of the deliveries examined, 105 were via caesarean section, 390 through vaginal delivery, whilst 210 delivery methods were unknown or unavailable.
The causes of death varied significantly. Congenital infections and birth defects each accounted for three per cent of deaths, whilst chorioamnionitis and membrane complications caused two per cent.
Multiple single-percentage causes were identified: maternal infections, neonatal preterm birth complications, obstructed labour and foetal malpresentation, other maternal factors, placental complications, umbilical cord complications, neonatal sepsis, and other infections each accounted for one per cent of deaths.
For two per cent of cases, the cause of death remained undetermined.
Researchers managed to determine causes of death in 78 per cent of the deceased babies
Leading causes
"This means that maternal hypertension, placental and delivery complications, chorioamnionitis, and obstructed labour and foetal malpresentation account for over 50 per cent of maternal conditions causing stillbirths in Kisumu," Dr Akelo observed.
Maternal hypertension topped the findings with 70 incidents, followed by placental complications with 42 cases, labour and delivery complications with 38 cases, and chorioamnionitis and membrane complications with 37 cases. Obstructed labour and foetal malpresentation recorded 25 cases, umbilical cord complications 14 cases, whilst HIV and malaria each accounted for 5 cases.
The researcher explained that labour, delivery, placental complications, preterm labour, maternal hypertension, multiple gestation, and obstructed labour and foetal malpresentation contribute to over half of foetal deaths.
"Hypoxia remains the biggest killer of babies in Kisumu and Kenya," he warned, noting that 315 deaths—82 per cent—were caused by perinatal hypoxia due to maternal hypertension, placental, and labour complications.
The study also highlighted an emerging threat: 53 stillbirths and early neonatal deaths had sepsis in the causal chain, with Klebsiella pneumoniae and Escherichia coli identified as the top causes of neonatal sepsis deaths.
Both bacteria belong to the Enterobacteriaceae family and are common causes of hospital-acquired and community-acquired infections, including urinary tract infections, bloodstream infections, pneumonia, and intra-abdominal infections.
Alarmingly, Dr Akelo revealed that in Kisumu, Klebsiella pneumoniae has developed resistance to 14 antibiotics: Ceftazidime, Co-trimoxazole, Cefepime, Cefuroxime, Amoxicillin-clavulanate, Gentamicin, Ciprofloxacin, Chloramphenicol, Meropenem, Imipenem, Amikacin, Piperacillin-tazobactam, Ceftiaxome, and Ceftriaxone.
To prevent stillbirths and neonatal deaths, he emphasised that focus should be on improving antenatal and obstetric care and management, clinical management and quality of clinical care, as well as encouraging health-seeking behaviour.
"The 92 per cent of stillbirths and 93 per cent of neonatal deaths we found are very much preventable," Dr Akelo assured, offering hope that proper intervention could dramatically reduce Kenya's devastating infant mortality statistics.
